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IF 5.6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatology Communications Pub Date : 2024-10-10 eCollection Date: 2024-11-01 DOI:10.1097/HC9.0000000000000477

Nicole E Rich, Patricia D Jones, Hong Zhu, Tanushree Prasad, Amy Hughes, Sandi Pruitt, Caitlin C Murphy, Karim Seif-El-Dahan, Darine Daher, Gloria Figueroa, Stephanie Castaneda, Lisa Quirk, Michael Gonzales, Osiris Carranza, Samantha Bourque, Nargis Baset, Adam C Yopp, Amit G Singal

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引用次数: 0

摘要

背景：尽管很少有研究充分考虑到临床重要因素和健康的社会决定因素（包括邻里社会经济状况），但仍有关于 HCC 预后的种族和民族差异的报道：尽管很少有研究充分考虑到临床重要因素和健康的社会决定因素（包括社区社会经济状况），但已有关于 HCC 预后的种族和民族差异的报道：我们对 2010 年 1 月至 2018 年 8 月期间在美国 4 个大型医疗系统新诊断出的 HCC 患者进行了一项回顾性多中心队列研究。我们使用多变量逻辑回归和特定病因 Cox 比例危险模型来确定与早期 HCC 表现和总生存率相关的因素：在2263名HCC患者中（37.6%为非西班牙裔白人，23.5%为非西班牙裔黑人，32.6%为西班牙裔，6.4%为亚裔/其他族裔），42.0%的患者处于早期阶段（巴塞罗那临床肝癌0/A期）。在完全调整模型中，黑人与白人在早期发病方面持续存在差异（OR：0.63，95% CI：0.45-0.89），但西班牙裔与白人之间没有差异（OR：0.93，95% CI：0.70-1.24）。白人患者的中位生存期为 16.2 个月（IQR：5.8-36.8），而西班牙裔患者为 15.7 个月（IQR：4.6-34.4），黑人患者为 10.0 个月（IQR：2.9-29.0），亚裔/其他患者为 9.5 个月（IQR：3.4-31.9）。在调整了个人人口统计学和临床因素后，黑人与白人的存活率差异依然存在（HR：1.30，95% CI：1.09-1.53），但在加入 HCC 分期和治疗（HR：1.05，95% CI：0.88-1.24）后，或在完全调整模型（HR：0.97，95% CI：0.79-1.18）中，黑人与白人的存活率差异不再存在。在完全调整模型中，西班牙裔-白人（HR：0.87，95% CI：0.73-1.03）和亚裔/其他白人（HR：0.85，95% CI：0.63-1.15）的生存率差异无统计学意义，但高社会经济地位社区的患者死亡率较低（HR：0.69，95% CI：0.48-0.99）：结论：在一个HCC患者多中心队列中，HCC预后的种族和民族差异可部分归因于诊断时肿瘤分期和邻近地区社会经济地位的不同。这些数据为干预和减少差异提供了参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Impact of racial, ethnic, and socioeconomic disparities on presentation and survival of HCC: A multicenter study.

Background: Racial and ethnic disparities have been reported for HCC prognosis, although few studies fully account for clinically important factors and social determinants of health, including neighborhood socioeconomic status.

Methods: We conducted a retrospective multicenter cohort study of patients newly diagnosed with HCC from January 2010 through August 2018 at 4 large health systems in the United States. We used multivariable logistic regression and cause-specific Cox proportional hazard models to identify factors associated with early-stage HCC presentation and overall survival.

Results: Of 2263 patients with HCC (37.6% non-Hispanic White, 23.5% non-Hispanic Black, 32.6% Hispanic, and 6.4% Asian/other), 42.0% of patients presented at an early stage (Barcelona Clinic Liver Cancer stage 0/A). In fully adjusted models, there were persistent Black-White disparities in early-stage presentation (OR: 0.63, 95% CI: 0.45-0.89) but not Hispanic-White disparities (OR: 0.93, 95% CI: 0.70-1.24). Median survival was 16.2 (IQR: 5.8-36.8) months for White patients compared to 15.7 (IQR: 4.6-34.4) months for Hispanic, 10.0 (IQR: 2.9-29.0) months for Black, and 9.5 (IQR: 3.4-31.9) months for Asian/other patients. Black-White disparities in survival persisted after adjusting for individual demographics and clinical factors (HR: 1.30, 95% CI: 1.09-1.53) but were no longer observed after adding HCC stage and treatment (HR: 1.05, 95% CI: 0.88-1.24), or in fully adjusted models (HR: 0.97, 95% CI: 0.79-1.18). In fully adjusted models, Hispanic-White (HR: 0.87, 95% CI: 0.73-1.03) and Asian/other-White (HR: 0.85, 95% CI: 0.63-1.15) differences in survival were not statistically significant, although patients in high-SES neighborhoods had lower mortality (HR: 0.69, 95% CI: 0.48-0.99).

Conclusions: In a multicenter cohort of patients with HCC, racial and ethnic differences in HCC prognosis were explained in part by differences in tumor stage at diagnosis and neighborhood SES. These data inform targets to intervene and reduce disparities.

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来源期刊

Hepatology Communications GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

8.00

自引率

2.00%

发文量

248

审稿时长

8 weeks

期刊介绍： Hepatology Communications is a peer-reviewed, online-only, open access journal for fast dissemination of high quality basic, translational, and clinical research in hepatology. Hepatology Communications maintains high standard and rigorous peer review. Because of its open access nature, authors retain the copyright to their works, all articles are immediately available and free to read and share, and it is fully compliant with funder and institutional mandates. The journal is committed to fast publication and author satisfaction.